What should you know about low pressure headache?

Here, low pressure usually refers to reduced pressure of cerebrospinal fluid around the brain and spinal cord, rather than low blood pressure. The headache may begin or intensify after sitting or standing and ease after lying flat. Neck discomfort, nausea, light sensitivity, dizziness or hearing changes can occur.

The pattern is not specific. Dehydration, viral illness such as a Common Cold or COVID-19, sinus disease such as Chronic Sinusitis, and Allergic Rhinitis can cause other headache patterns. A recent spinal procedure, injury or persistent fluid leak is relevant history to share.

Arrange a medical assessment if the headache is new, strongly posture-related, persistent or follows a procedure. Note when it starts, how quickly lying down helps, associated symptoms, recent illness and medicines. Resting flat may reduce discomfort while you arrange advice, but do not assume that extra fluids or caffeine will address the cause.

A clinician may examine you and decide whether imaging or specialist review is needed. Avoid strenuous activity until you have guidance if the headache followed an injury or procedure.

Seek emergency care for a sudden severe headache, new weakness, confusion, seizure, fainting, repeated vomiting, fever with a stiff neck, vision loss or difficulty speaking. Seek prompt assessment after a head injury, or if the headache occurs with Heat Exhaustion, Dengue Fever symptoms or severe dehydration.

Does my posture-related pattern suggest a fluid-pressure problem? Could another illness explain it? Do I need examination or imaging? What activity, pain relief and hydration advice is appropriate while I wait?